| NPI | 1326197716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN 283) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MN R-149064-8) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-09-28 |